Provider Demographics
NPI:1043694243
Name:KWYZLA, ERIN M (APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:M
Last Name:KWYZLA
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 W PLEASANT GROVE RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72758-7033
Mailing Address - Country:US
Mailing Address - Phone:479-326-8525
Mailing Address - Fax:
Practice Address - Street 1:2301 W PLEASANT GROVE RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72758-7033
Practice Address - Country:US
Practice Address - Phone:479-326-8525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-17
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA004495363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily